Provider Demographics
NPI:1194883249
Name:GINO S RAMUNDO FAMILY CHIROPRACTOR PC
Entity type:Organization
Organization Name:GINO S RAMUNDO FAMILY CHIROPRACTOR PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GINO
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAMUNDO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-943-1444
Mailing Address - Street 1:9226 KENNEDY BLVD
Mailing Address - Street 2:2ND FLR
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5312
Mailing Address - Country:US
Mailing Address - Phone:201-861-4447
Mailing Address - Fax:201-861-3330
Practice Address - Street 1:9226 KENNEDY BLVD
Practice Address - Street 2:2ND FLR
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5312
Practice Address - Country:US
Practice Address - Phone:201-861-4447
Practice Address - Fax:201-861-3330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ553799Medicare PIN
NJ043022Medicare PIN